Prevalence of Anal Fissure in Patients with Anorectal Disorders: A Single-centre Experience

Abstract

Introduction: Anorectal disorders including fissure and hemorrhoids are among the most common digestive complications. To our knowledge there is no literature available on the prevalence of anal fissure from our region of study (Bhopal, Madhya Pradesh, Central India). Aim: To estimate the prevalence of anal fissure among the patients of anorectal complaints. Materials and Methods: This was a cross-sectional observational study conducted from January 2014 to December 2015. All the patients visiting the Department of Surgery with anorectal complaints were screened. Patients of either sex, more than 18 years of age, with complaints of anorectal pain/ bleeding/discharge or prolapse of rectum were included in the study. The diagnosis of enrolled patients was based on clinical findings of anorectal evaluation by digital examination and proctoscopy. Results: Overall, 629 patients were enrolled in the study. The mean (SD) age of patients was 38.27 (9.25) years and a total of 438 (69.63%) of patients were males. Around half of the patients (n=308; 48.97%) had normal BMI. A total of 112 (17.81%) of patients were diagnosed to have an anal fissure. Mixed dietary habits and history of constipation were found to be associated with the prevalence of fissure. Similarly, patients with no exercise or physical activity had more prevalence of fissure than patients who exercised on a regular basis (19.87% versus 11.54%). The majority of patients had bleeding and pain (n=326); out of these patients, 89 (27.30%) had an anal fissure. Conclusion: The prevalence of anal fissure among patients with anorectal complaint was found to be around 18%. Mixed dietary habits and constipation could be considered as risk factors for the anal fissure.

Keywords

• constipation
• epidemiology
• fissure-in-ano
• risk factors